Modulation of oxidative stress and microinflammatory status by colloids in refractory dialytic hypotension

BMC Nephrology

Abbes Benmaadi¹  Eric Illouz²  Thomas Bourlet¹  Christelle Loridon¹  Mireille Griuncelli¹  Guy Rostoker¹ 

[1]Service de Néphrologie et de Dialyse, Hôpital Privé Claude Galien, 20 route de Boussy, 91480 Quincy sous Sénart, France

[2]Service de Cardiologie, 20 route de Boussy Saint Antoine, 91480 Quincy sous Sénart, France

关键词: oxidative stress;    microinflammatory status;    20% hyperoncotic albumin;    4% gelatin;    dialytic hypotension;   

Others  :  1083225
DOI  :  10.1186/1471-2369-12-58

 received in 2011-03-18, accepted in 2011-10-20,  发布年份 2011

【 摘 要 】

Background

Intradialytic hypotension may adversely affect the outcome of chronic hemodialysis. Therapeutic albumin has powerful anti-oxidant and anti-inflammatory properties. We have recently shown that systematic colloid infusion during hemodialysis sessions improves hemodynamic parameters in most dialysis hypotension-prone patients unresponsive to usual of preventive measures.

We postulated that frequent hypotensive episodes may lead to a noxious inflammatory response mediated by oxidative stress induced by ischemia-reperfusion. The aim of this study was therefore to analyze the effect of 20% albumin and 4% gelatin infusions on oxidative stress and microinflammatory status in hypotension-prone patients unresponsive to usual preventive measures.

Methods

Prospective cross-over study (lasting 20 weeks) of routine infusion of 200 ml of 20% albumin versus 200 ml of 4% gelatin in 10 patients with refractory intradialytic hypotension. We analyzed the effect of 20% albumin and 4% gelatin on microinflammatory status, oxidative stress, serum nitrite and nitrate levels by analysis of variance.

Results

A significant decrease in serum ceruloplasmin and serum C3 was observed during the albumin period (p < 0.05, repeated measure ANOVA). A significant decrease in serum hydrogen peroxide was seen during albumin and gelatin administration (p < 0.01, repeated measure ANOVA) and a very large decrease in serum lipid peroxides was observed during the albumin period only (p < 0.01, Friedman test). Serum lactoferrin, serum proinflammatory cytokines and serum nitrite and nitrate levels remained stable during the different periods of this pilot trial.

Conclusions

We conclude that the improvement in microinflammatory status observed during colloid infusion in hypotension-prone dialysis patients may be related to a decrease in ischemia-reperfusion of noble organs, together with a specific reduction in oxidative stress by albumin.

Trial registration

ISRCTN 20957055

【 授权许可】

   
2011 Rostoker et al; licensee BioMed Central Ltd.

【 图 表 】

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